Pattern of intrathecal immunoglobulin synthesis in pediatric patients with infectious meningoencephalitis

ABSTRACT Intrathecal immunoglobulin synthesis is part of the immune response in the central nervous system (CNS). In this study we demonstrate that age, the features of the biological agent, and epidemiological factors modulate the pattern of intrathecal immunoglobulin (Ig) synthesis. We also describe the pattern of intrathecal Ig in patients suffering from bacteria, virus, or parasites induced meningoencephalitis is the general objective of the study. The description of the pattern of intrathecal Ig and IgG subclasses in children with eosinophilic meningoencephalitis due to Angiostrongylus cantonensis and study the pattern of intrathecal immune response and the functionality of the blood-cerebrospinal fluid (CSF) barrier in children suffering from meningoencephalitis due to Neisseria meningitidis, Echovirus 4, 6, 9, 16 and Coxsackie A9 and B5; and propose novel applications and modifications of reibergram,. Each one of the infectious diseases studied exhibit a characteristic pattern of intrathecal immunoglobulin synthesis. These patterns are detected earlier in children than in adults with similar infections. Additionally, significant differences were found in the Ig patterns during epidemics as compared to non-epidemic infections. The reibergram is therefore a useful tool in the characterization of epidemics. The reibergram was also adjusted for IgG subclasses, being especially relevant for IgG3. The pattern of intrathecal Ig for these diseases in children is reported here for the fist time. The novel use of reibergrams in the evaluation of IgG subclasses opens new avenues for neuroimmunology in general and particularly for pediatric and tropical neuroimmunology.